Achilles Tendonitis Treatments - The Good, the Bad, and the Useless
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- Опубліковано 9 чер 2024
- There's no one-size-fits-all treatment for Achilles tendonitis/tendinopathy. However, there is a treatment approach that works best for most people, and this is backed up by research. In this video, Treat My Achilles co-founder Maryke Louw explains this approach. She also cautions against other treatments that are useless or may harm your Achilles tendon even further.
👉 The video mentions heel lift shoe inserts to help your Achilles pain to calm down. Here are some examples on Amazon:
- Makryn adjustable: geni.us/lA7G
- XINIFOOT: geni.us/QiGjBE
- Ailaka gel: geni.us/pZUEZ
🌟Need more help with your injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your Achilles injury and a tailored treatment plan: www.treatmyachilles.com
📽️Other videos mentioned in this video:
▶️ Why Relative Rest is Important for Achilles Tendinopathy Treatment: • Why Relative Rest is I...
▶️ Exercises For Achilles Tendonitis/Tendinopathy - What, When, How Often? • Exercises For Achilles...
▶️ Persistent/Chronic Achilles Pain? How Understanding Pain Can Help: • Persistent/Chronic Ach...
▶️ Achilles Tendonitis Treatment - Pain vs. Scan Results: • Achilles Tendonitis Tr...
▶️ Laser Treatment for Achilles Tendonitis - Does It Work? • Laser Treatment for Ac...
▶️ Is Ice Or Heat Better For Achilles Tendonitis? • Is Ice Or Heat Better ...
▶️ PRP Injections for Achilles Tendinopathy - Do they Work? • PRP Injections for Ach...
▶️ Supplements for Achilles Tendonitis: • Supplements for Achill...
▶️ Learn how the Menopause can Cause Achilles Tendonitis: • Learn how the Menopaus...
▶️ Hormone Replacement Therapy, the Menopause, and Achilles Tendonitis: • Hormone Replacement Th...
▶️ Anti-inflammatories (NSAIDS), Achilles Tendonitis & Other Injuries - When to Use It & When Not To: • Anti-inflammatories (N...
▶️ How Long does Achilles Tendonitis Recovery Take? • Recovery Times for Ach...
▶️ Night Splints for Achilles Tendonitis - A Waste of Money. Do this Instead: • Night Splints for Achi...
▶️ Achilles Tendinopathy: Corticosteroid Injections: • Achilles Tendinopathy:...
▶️ Using A Boot for Achilles Tendinopathy or Pain: • Using A Boot for Achil...
▶️ DON'T Do Cross Friction Massage for Achilles Tendinopathy: • DON'T Do Cross Frictio...
Chapters:
00:00:00 Introduction
00:00:53 The best treatment for Achilles tendonitis
00:08:27 Treatments that may reduce pain (but won't heal your tendon)
00:16:19 Treatments that may speed up healing
00:18:27 Achilles tendonitis treatments for specific situations
00:23:21 These treatments are a waste of time and money
00:24:50 Treatments that can make your Achilles tendonitis worse
00:27:37 How we can help
References:
Challoumas, Dimitrios, et al. "How does surgery compare to sham surgery or physiotherapy as a treatment for tendinopathy? A systematic review of randomised trials." BMJ Open Sport & Exercise Medicine 5.1 (2019): e000528.
Cook JL. “Ten treatments to avoid in patients with lower limb tendon pain.” British Journal of Sports Medicine 2018;52:882.
Cook JL, Rio E, Purdam CR, et al. “Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?” British Journal of Sports Medicine 2016;50:1187-1191.
De Vos, R.-J., et al. (2021). "Dutch multidisciplinary guideline on Achilles tendinopathy." British Journal of Sports Medicine 55(20): 1125-1134.
Hanlon, S. L., et al. (2021). "Beyond the Diagnosis: Using Patient Characteristics and Domains of Tendon Health to Identify Latent Subgroups of Achilles Tendinopathy." J Orthop Sports Phys Ther 51(9): 440-448.
Malliaras, P. (2022). "Physiotherapy management of Achilles tendinopathy." Journal of Physiotherapy 68(4): 221-237.
Scott A, Docking S, Vicenzino B, et al. “Sports and exercise-related tendinopathies: a review of selected topical issues by participants of the second International Scientific Tendinopathy Symposium (ISTS) Vancouver 2012. British Journal of Sports Medicine 2013;47:536-544.
Slagers, A. J., et al. (2021). "Psychological factors during rehabilitation of patients with Achilles or patellar tendinopathy: a cross-sectional study." Physical Therapy in Sport 50: 145-152.
Vajapey S, Ghenbot S, Baria MR, Magnussen RA, Vasileff WK. “Utility of Percutaneous Ultrasonic Tenotomy for Tendinopathies: A Systematic Review.” Sports Health. 2021 May-Jun;13(3):258-264.
Van Der Vlist, A. C., et al. (2021). "Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials." British Journal of Sports Medicine 55(5): 249-256.
Zhi, X., et al. (2021). "Nonoperative treatment of insertional Achilles tendinopathy: a systematic review." Journal of Orthopaedic Surgery and Research 16(1): 1-12.
👉Some links here are to places where you can buy something relevant to this video. If you do, we may get a small commission at no extra cost to you.
👉 In the video I mention heel lift shoe inserts to help your Achilles pain to calm down. Here are some examples on Amazon:
- Makryn adjustable: geni.us/lA7G
- XINIFOOT: geni.us/QiGjBE
- Ailaka gel: geni.us/pZUEZ
Remember to use them in both shoes!
If you buy anything via these links, we may get a small commission at no extra cost to you.
Thanks for this
Hi
Occasionally my Achilles tendon flares up and I get pain after playing racket sports, do you recommend adding heel raise inserts into my sports shoes when playing racket sports?
I use lifts and I'm 6ft tall. lol I don't want to ever wear high heels again but... here we go again. Maybe I shouldn't have stopped
Thank you, im so glad I found your channel. Im 61 yrs old and this is my 3rd injury. Hopefully your videos will help me me 😢 i do not want surgery. Thats what the dr. Wants. I just had a hip replacement on my opposite leg. Thank you.
This is absolutely the best video on Achilles Tendinopothy. So good. Thank you for taking time to make this video.
You're welcome!
The Stress and anxiety section was a real eye opener for me. I knew about cortisol but didn’t know that the brain can’t tell the difference between emotional stress and physical stress! Very informative and helpful, thanks so much.
😊
I've struggled with this injury for YEARS...I thought that it was "normal" to feel this pain. This channel is changing my life, thank you.
Thanks for the comprehensive explanations.
You are welcome!
Thank you. This provided some clarity in how I should be approaching my treatment
Maryke's videos are much more comprehensive than any others and she's much more knowledgeable than the PT and Podiatrist that I've been seeing. I'm going to stop going to them and will see an accupuncturist and look into electroshockwave therapy and PRP. Thanks Maryke - I wish that I could see you for PT!
Calf raises helped alot thanku so muchh ❤️
excellent video!! all explanations I needed to understand what is going on with my foot. ❤
So glad!
Really useful Maryke, thank you
You're very welcome!
Thanks for the info!
You're welcome!
So professional. Thanks.
You're welcome!
Thank you! Just the video I was looking for. I can't seem to get better, and physio has been awful. So lucky to find you.
Welcome!
Brilliant video, thank you
Very welcome
Good science and good advice. Thank you.
Our pleasure!
Great videw... thanks for your explanation.
My pleasure!
Excellent video. Thank you very much for the informative video.
Our pleasure!
This is helpful. Thank you.
Glad it was helpful!
Wow.
Most well-referenced youtube-video I've ever seen.
Thank you so much information here that will help me with my pain
You're welcome!
I'm a 30 something year old active male. Have had Achilles tendonitis for over 3 years. I've now learnt to live with it. It is painful and at times very painful but after about 2km in a run, the pain subsides. I once stopped running entirely for about 2 months (felt like a year) and it didn't solve my problem so I slowly started running again and then racing. I still suffer (mornings are the worst) but it's better than not running.
Thank you for sharing.
I did this. Managed the pain for years and ran some good races. Recently started doing speed work for a marathon on attempt and it flared up massively. Haven't run for 1.5 years but can now walk around pain free and I can get away with gentle run/walking.
Got an appointment with these guys on Monday so hopefully I'll get rid of the remaining issues and make a full/pain free return soon!
Try a PRP injection! It's a game changer!
I had it all through my 30's. I cut back on carbs considerably, now i'm in my mid 40's and have no problems.
@@KeithLou-dw6ef did you stop running for a long period to heal?
Thank you very, very much! ❤
You're welcome 😊
Thank you great video.
You are welcome!
I have been a runner nearly all my life, and at a fairly high level. I have had Achilles issues off and on for years. I have tried everything. Nothing works except.......PRP injection and complete immobilization after the inject by wearing a boot for at least 6-8 weeks. This is the only thing that solved the issue. Now I make certain I stay away from running shoes with less than 10mm drop and do a lot of foam rolling and self massage.
Have never had this issue but the day I changed my running shoes from Hoka speedgoat4 to nike vapour fly, I got the injury, its been 5:weeks of inactivity. Sucks
@@davidndirangu3454 you may want to try a shoe with a drop of no less than 10 MMS until this subsides. Although it has been my experience that Achilles issues only resolve with no running.
thx very much!
You're welcome!
Thank you. Marathon runner here who has a good weight and likes to lift weights. Surgery for Haglunds 10/2022. Was non weight bearing for 6 weeks and another 4 weeks in a boot. Never fully recovered. Low level pain that got worse. Tore the meniscus on my opposite knee with a fall while on crutches. After trying to rehab for this too I had to have the knee cleaned up. Immediate relief with the knee after surgery. Worked with PT as prescribed for both conditions. Tried dry needling. After not making reasonable progress went back to doctor and xray (7/2023) determined I had a reaction, periosteal, and had another bone spur. Surgery 9/6/2023, did not need Achilles detached to remove spur this time. Had PRP and debulking of the tendon when additional spur was removed. Was 3 weeks non weight bearing and then several days in a boot. Again, plateau with PT and insertional tendonitis. Tried dry needling. Doctor wanted to discuss laser therapy after the New Year. Bypassing laser, waiting till mid 1/2024 felt like another month of lingering. Trying shockwave currently and I've noticed less pain and the heat on the tendon has decreased. I have 4 more sessions of shock therapy and will re-evaluate with PT. What I learned from this video is HRT may be something I ask about if I can't break the plateau. I'm 56 and still in the perimenopause stage. I truly appreciate the stress and anxiety explanations too. I've had a couple deaths in the last 6 months and when I would talk to the PT & doctor about how the Achilles is feeling it was literally bringing me to tears. I feel like there are some other options available, if needed, to promote healing. Thanks again
Thanks for sharing, and good luck with your recovery!
Same! I am now ready to look at HRT- so glad for this
Thanks a million! Are there any effective exercises for this case?
Here's our video about the exercises: ua-cam.com/video/Dp8gzq9zoy4/v-deo.html
Should have found you months ago. Thank you.
You're welcome!
Thank you, very useful indeed and have been making some of these mistakes with the healing, what about compression socks to walk/run in any benefit or also could make it worse?
It doesn't really provide any benefit. There's no strong contra-indication for it but it depends on how sensitive your injury is to compression - sometimes low level compression sustained for a longish period can also irritate the tendon.
I've had achilles tendonitis for exactly 12 months now. At the beginning I had pain even to talk for 30 seconds but I've been using your youtube videos for rehab and it has benefited quite alot. I've tried shockwave therapy 6 times + HILT as well. I can do 15kg weighted eccentric heel drops (15 reps) + double leg skips (40 reps) + 1 injured leg skips (15 reps) without much problem. Short distance walking ain't a problem but I do feel the niggle when I walk over 3km. I haven't had the courage to run worrying about flare ups. What are some other ways to build up from here? Thanks.
Your tendon does sound robust enough to run - it can be useful to keep the distance steady at what you can currently walk (3km) and then just add in a few (about 5) intervals of 30sec jog, 1min walk into the middle of the walk. And very slowly build from there.
But this advice may not be right for you because I obviously don't know all the details around your situation etc. If you wanted more specific help, this is something our team can help with via video call - you can read more about how this works here: www.treatmyachilles.com
Maryke , love your videos been helping me alot in my recovery. But the other day i think i did too much in my strengthening, exercises and now my whole leg is tight with a lot of pain and inflammation Highup in my Achilles right under my calf is that normal? Should I be doing something different in my recovery?
It sounds as if you may have overworked them so you will have to take it easy and allow your calves to recover - gentle massage may also help. Once they have calmed down, ease into your rehab again. But it sounds as if you need to take it much easier than before. Also, remember that I've not assessed you so this advice may not be right for you, but you can find out more about handling flare-ups in this video: ua-cam.com/video/9Pps6aQd2X8/v-deo.html
If you wanted more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
Hi I find this video really useful! Thank you
You're welcome!
Last year, my achilles hurts real bad. Couldnt walk straight and drive. Went to chiropractor and somewhat fixed it. Even without the pain now, i feel slight tightness when i flex my foot downwards.
Your videos are always the very best. I'm trying to figure out what is best to do and to avoid when I have tarsal tunnel syndrome, AND then developed Achilles tendinitis from overstretching 🤦🏼♀️😥
So, the main thing is to avoid going into positions of stretch for a while e.g. only do heel raises to floor level and make sure you wear shoes etc. that help support your foot and avoid over-pronation.
If you wanted more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
@@TreatMyAchilles thank you so much for taking the time!
@@TreatMyAchilles are heel raises still a good idea if I ALSO developed posterior tibial tendonitis as well? Lol 🤦🏼♀️🤦🏼♀️
I have some inflammation and tenderness for 5 weeks- I was told I needed to rest and monitor pain while exercising. So far quick heat sits bath covering ankle - mild usage of coolness and swimming ( freestyle- breast stroke causes discomfort) help. Question- can I ride a bike, carefully? Are there any foot positions to be wary of while pedaling? I have found walking downhill less painful than walking uphill. Thank you for your information. I started today to do the suggesting strengthening exercises. My doc made none of these suggestions
In some cases, an injured Achilles tendon that is very sensitive to being stretched might not like cycling, so start off with a short, easy session at low resistance, and check how your tendon responds in the next 24 hours. If everything is fine, you can gradually increase your sessions.
Make sure that your saddle isn’t too low; the lower your saddle, the more your tendon will have to stretch as you bring your foot around. If you wear cycling shoes, check that the one on the injured side doesn’t press into the injured part of your tendon.
Ordered the Makryn adjustable, lost work due to the pain from being on my feet 8.5 hours on hard floors. I am desperate for something to help.
At the outset, thanks so much for the comprehensive analysis of treatment options for Achilles Tendonitis (AT) . I have a couple of questions 1. Is there a video that explains diagnosis for AT? 2. Are small fiber neuropathy (SFN) and AT related? 3. People (seniors in particular) who are not into sports and didn't have any injuries as such develop AT in both legs?
Here's the video about diagnosis: ua-cam.com/video/cNOxd3w37K0/v-deo.html
I think I also touch onto the subject of getting Achilles injuries without doing sport in that video - it is often related to other heal issues or even medication. But I am not familiar with SFN, so I don't know if that can impact it.
This is amazing I was just looking for this now I am very overweight (obese, and high belly fat) high stress and anxiety (many bereavements ) and have Achilles tendonitis for last 6 weeks. I think it's insertional
I used a massage ball gu,n which helped with the pain
So anything to help with that is big
I had it all through my 30's. I cut back on carbs considerably, now i'm in my mid 40's and have no problems.
Thanks for a great video! I got achilles tendinitis after doing an 85km trail run mid October for charity and after 2 months it's still a bit painful. Was thinking of getting a boot for it, but after watching this video have reconsidered it. I tried a light 5km run a few days ago but don't think I am ready to get back to running yet. Will swim for a month and then maybe cycle for a month after that, hopefully will be able to get back to running end of Feb. Getting a bit worried as Comrades Ultra Marathon is beginning of June and I still need a few months of training and then rest.
Thanks for sharing!
I started getting PT last November. Had a 50k race the week after and got 9th. Rested for about 1 week or 2 because I had my first 50 miler in jan2024. Then I thought I was good ,found out I got accepted into leadville100 so I began building elevation gain and miles. Now I have a big flare up and currently resting.
Hi, I saw a similar comment about the tendon with a dull ache in plantar flexion which I do get (especially at the very top of the movement). Also I get pain when planting the foot with the heel in front of the knee. However, I’ve been being treated with tendinopathy for the past 6 months. Is this more of a posterior impingement issue?
If so do you offer treatment for this?
Yes, this sounds like it is likely got an element of posterior impingement in the joint - you can have both conditions at the same time but it may also be just that on its own. Yes, we do offer treatment for that. The best physios on our team to help with that are Kevin and Steph. You can find more info about the video consultations on our website: www.treatmyachilles.com/
Compression works for healing process?
Very informative video. I just strained my Achilles walking up a hill several times in one day. I had plantar fasciitis and Hallux Rigidus for about five months but finally found the right shoes and insoles and had no pain for two months. So, I can’t do the heel raises because of my Hallux Rigidus, What other exercises would you suggest? Thank you for all your expert advice.
Two things that could work is doing isometrics or using an exercise band - this video is about metatarsalgia but I explain these exercise options in there ua-cam.com/video/NWB6dIjq3D8/v-deo.html
I notice not running helps heal the tendons. Also, wearing Birkenstock shoes help ease the pain so I can walk easily. I’m doing a half marathon this weekend and am a bit scared but am going to go for it, but watching your video is comforting.
Thanks for sharing!!
this is very helpful. I realised my left achilles pain always triggers during inclined walks and climbing stairs. it’s specially painful in the morning and can’t walk properly when applying pressure in the heel. But the weird thing was I don’t feel any pain at rest or applying pressure like massage. so when i went to the doctor and press the area there’s no pain at all. it made me feel like Im faking it or something😅. Elevated running/walking shoes with ankle support helps me walk by a lot during the 1st month I acquired it.
Thanks for sharing!
My achilles tandon will be very tight still i am not walking how to flexible will come?
Thank you for your video you have given me hope, I was kind of lost. Male in my 30s six moths with this, what about the bike ? I’ve been felling quite pain, after doing it, should I avoid it ?
Cycling can sometimes irritate the tendon because it takes the foot into dorsiflexion (so stretches it gently) - The rule with rehab and exercise is usually that it is OK to do as long as:
1. It only causes a slight discomfort while doing it, AND
2. It does not cause an increase in your pain and swelling that lasts for more than 24 hours
I'm very surprised the ultrasound is seen as useless. I have had tendonopathy for many years and find the novasonic ultrasound is the only thing that will give me some form of relief if I'm having a flare up.
Having said that, I do find risers helpful in taking the pressure off. When my ankles are too painful to stand on, I have found using a recumbant bike and wearing compression socks a good way to maintain movement and encourage circulation flow in the ankles and calve muscles without causing pain.
An interesting video though. Thank you :)
Hi not being an internet knobhead ,just saying your novasonic is not ultrasound it is intrasonic ,whatever it is ,if it helps it helps!
@@petemayes1940 You are correct. Unfortunately I was responding though my mobile and predictive text obviously didn't approve of the word intrasonic. I've had worse text bloopers!
@@gwynhyfer ha ha ,good luck!
Same. My novasonic brings noticeable relief and seems to aid treatment
One more question: I have a three story house with a basement also. I work from home on my third floor and have to run up and down stairs to let dogs outside, etc. and even have further trips down to the basement to my other work area. Are all these stairs a bad thing for Achilles tendinitis healing?
Stairs can aggravate the Achilles when it is injured so it may be best if you can adjust your situation for a while so you don't have to do as many stairs.
You haven’t mentioned acoustic wave therapy. Was wondering what your opinion is of that. I had it done six months ago it relieves pain for several months until I resumed all normal activities such as country line dancing and Started running my errands again as my normal routine. I now just started my second round of acoustic therapy. I’ve been going through a lot of different treatments over the last 23 months. PT just inflamed it more. But I agree with you about wearing heels. My doctor told me not to wear them and I think that’s part of the problem it’s not feeling better.
The acoustic wave therapy can sometimes help reduce pain, but like you found, it doesn't actually strengthen the tendon. So, as soon as you then ask the tendon to work, it flares up because it's not built the strength it needs and lost through the injury. So, you can use the therapy to reduce pain but then you have to carefully strengthen the tendon. If the physiotherapy caused your tendon to be more inflamed, then the exercises they gave you we're right for you. There are so many different ways in which to strengthen the tendon and what works for one person can often make the next feel much worse - your exercises should never cause you pain and if they do, they have to be adjusted and changed.
I discuss rehab exercises in this video: ua-cam.com/video/Dp8gzq9zoy4/v-deo.html
But if you ever wanted help with your rehab, this is something our team of physios can assess and provide rehab for via video call. You can find out more about how the video consultations work here: www.treatmyachilles.com
Maybe I missed it but 4 acupnucture visits eliminated my pain. I had been limping for a month, nothing was working but acupuncture did.
Thank you for sharing. Acupuncture can be useful to relieve pain. It is one of those treatments that don't have strong evidence to back it up but in practice I have found it works really well for some people but not for others. Definitely worth a try if your pain is not responding to other treatments.
I been struggling with this for a while. Though, I must ask, how much does weight take a part in tendinopathy? I don't know, or perhaps I don't remember if you mentioned anything about weight being a reason that could prevent progress for our achilles in any of your videos. I am curious what your take would be on this issue.
There is evidence that being overweight can contribute to getting tendinopathies - it has to do with how being overweight affects your general health. In our experience, being a bit overweight isn't that much of an issue - it is more when you are in the obese category that it might start to affect your recovery.
I have had insertional achilles tendonopathy for 12 months and tried PT, heel lifts, orthotics, PRP injection almost everything you mention. My Orthopedic dr wants to do an Isolated Gastrocnemius Recession- what is your opinion on this procedure?
That is something they sometimes do for plantar fasciitis, never for Achilles tendonitis. The types of surgery that I would consider if it was my own Achilles would be minimal invasive debridement (where they just scrape it) of the tendon or Tenex type treatment. You need to perhaps get a second opinion from a different doctor.
I have Achilles tendinitis right now. Very painful. Im in a removable walking boot. Going to physical therapy. The exercises she showed me to do dont seem relevant to the condition. Every video i have watched dosent show the exercises the physical therapist showed me to do. One is to stand facing the wall, with my hands against the wall, tuck my toes under and pulse 10x. The other is to keep my toes and heel on the floor and rotate my arch right and left 10x. I am to do that 2x a day. Each time i do the repetition 1x. She said using a towel and pulling on the foot to stretch it wont help. She said contrast baths dont help. She also said theres no scientific proof using ice or heat helps! Seriously? Icing it helps so much! Definitely not going back to that physical therapy office. Thank you for your video.
Those exercises actually sound oke to me. And icing it does not solve the cause of your issue.
I have had occasional (infrequent) achilles pain off and on for years... never made the connection that it usually showed up when activity change was specifically paired with higher stress / anxiety levels. Currently experiencing the tendon pain after my dog had a stressful week and a couple of walks with more than usual pulling (and some lunging at a cat) - stressful and a change in my exercise routine.
Thanks for sharing!
Thank you for so much to consider. What is the best collagen supplement to take? There are so many on the market. Some are cow-based and others from krill. Is there a benefit for one over the other
We're not experts on supplements, so can't say what type is best - it is worth watching our video on supplements to see what they did in the research studies: ua-cam.com/video/HMpcNOUhS14/v-deo.html These are examples of the types of supplements they used in the studies: Gelatine: geni.us/TPD0O and Hydrolysed collagen: geni.us/hFfp
Hello Dr. Maryke hope you are well and doing great where are you and company based exactly
We are based in the United Kingdom.
I am going to see a specialist next week so they can asses what i have
Did I have a botched Tenex procedure? My surgery was on November 22, 2023. I did the prescribed stretching after the procedure and wore a boot for 2 weeks. I have been going to PT 2x per week since January, doing the exercises on my own and I am not healing. I still have significant pain in my foot. I have a large bump on the back of my heel. And I also have pain in my upper thigh and hip. I am doing steps one at a time. I have cut back on walking because it is painful during and the next day. I have been running for almost 30 years but have not run since the end of July 2023. The doctor who did the procedure saw me for 3 follow up visits. At the last visit on 2/14/24, she told me I was an outlier in that the Tenex procedure did not work for me. she gave me a prescription for an additional 6 weeks of PT and told to call them if I needed anything. I feel like she was writing me off. I am in Philadelphia, PA and would like to go to another doctor. Can you advise or recommend anything?
If you also have pain higher up in your leg, it might be that you have more than one thing going on and that can be part of the reason why the Tenex wasn't that effective. If you wanted help with figuring it out and getting back to your normal activities, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
Been wearing a pneumatic boot for 6.5 weeks with 3 steriod injections. D/C from the boot yesterday for a trial week in a tennis shoe with shoe orthotics. This condition is horrible.
I tried prp, did not work unfortunately.
Great video. My achilles tendon seems to get relief when in the stretched position, and has more of a dull ache when 'compressed' i.e. plantar flexion of foot. Is this achilles tendinopathy or symptomatic of something else?
That is likely posterior ankle impingement (when the back of the ankle joint is irritated) - the pain is in the same general area of the Achilles because the joint is under it but the pain is increased when you point the toes (compresses the back of the ankle joint) and when you flex the foot into dorsiflexion it relieves it because the joint surfaces move away from each other. Very common injury in footballers or sports that require quick change of direction.
I have calf strain in boths legs and Achilles tendinitis in both, heels that hurt even to wear a tennis shoe. But the calfs really hurt and at days even worse that the tendinitis itself. And that gets me out of walking at home sometimes because of the pain... i even ripped a muscle in my calf because of that strain in the left calf...without noticing.. How to make it go away?
You may benefit from massage combined with rehab exercises to help strengthen your calves and tendons. A physiotherapist will be able to assess it for you and prescribe the best treatment.
Thanks so much for all this videos. I have watched several of these since I am facing this issue and I play tennis. How likely is it to tear up? The pain is there but after training and when standing up from a resting position. Can the tendon tear up? I have inserted achilles tendinitis. Thank you. 25:43
It is usually best to first make sure that you restore your tendon's full strength before playing sports with fast and strong movements like Tennis. Your physiotherapist will be able to advise you on whether your tendon is ready to play tennis or not.
@@TreatMyAchilles thanks so much.
Hi Maryke,
What is your opinion on EPTE (electrolisis percutanea terapeutica) therapy combined with heavy slow resistance protocol?
Would that be effective? Regards, Karolina
It depends on what substance you use in the EPTE - if it is an anti-inflammatory or steroid then I would stay away from it.
@@TreatMyAchilles No, it's a low intensity galvanic current applied to the tissue to induce a controlled inflammation. It's supposed to restart the healing process in the tendon.
Ah OK, I'm not familiar with that technique and its not something I've come across in the research either.
I tore my Gastroc on my less affected side and have so much less pain in my Achilles. My worse side is still so severe and my PT suggested that i get an MRI to check for abnormalities as it wasn't responding to PT.
One Ortho doc recommended injections. Another recommended the strayer procedure for Achilles lengthening, which is essentially what i did to my other leg. What are your thoughts on that surgery?
As soon as you lengthen the Achilles it loses some of its elastic recoil properties and you lose some of your ability to properly jump and run and push off, so I would stay away from that. Tearing the calf is very different from this because it affects the calf muscle tissue, not the tendon. I can't tell from your message if you tore your calf before or while you have had Achilles pain - if it is while then consider the fact that you will likely have used that side less while the calf was recovering and that that may actually have been what reduced your pain on that side. If you tore the calf before your Achilles got injured (long time ago) then I don't think it is related - it is quite common for one side to be more painful than the other side because we tend to favor one leg over the other when we move and exercise.
If you do opt for surgery then I would rather go for Tenex procedure or something like that but tendon lengthening is old school and not something recommended by current research.
The surgeon actually tears the medial gastroc then reattaches it, as a way to ease the tension on the Achilles, as a way to "lengthen" it. Does that seem like a better option?
what about corticosteroid nose spray for allergies can that have a negative effect on the healing?
Not as far as I know - it is only injecting into the tendon or taking tablets that might affect it.
Why cross friction massage is often recommended for tendinopathy if it has the potential to trigger a flare up? Does it have any other use cases?
I think it is perhaps a relic from the old days - we were also told to use it when I studies 20 years ago.
Can one of your physios help treat both insertional achilles and patellar tendonitis?
Yes, our team treat the whole person, not just the heel. The best physios on the team to consult about a combo of insertional AT and patellar tendonitis are Barry, Kevin and Jack. You can read more about the physios here www.treatmyachilles.com/about-us and the online treatment process and book an appointment here: www.treatmyachilles.com/treatment-packages
I did the cross stitch and it was so painful and I was using the massage gun and it was the worst pain ever ! 😅
Do you have any comments about Blood Flow Stimulation Therapy?
Here's our video about it: ua-cam.com/video/lh0IBZmq7kk/v-deo.html
I'm 69, female, & retired 5 yrs ago & have been walking barefoot all day every day.
About a year ago developed what I think is Tendinitis in both heels - but more especially right heel - which has become debilitating. However wearing slight heels & heel inserts does help considerably.
Some times I'll stand up to walk & be hobbling in pain - other times no problem at all.
When I'm in pain I am forced to walk flat-footed. This happens several times per day. Walking up/down stairs feels like the tendons are literally going to snap. Sharp pain! It feels as if my tendons have shortened & thickened.
There is visible inflamation swelling in the soft tissue below & on the sides of ankles.
There is also a definite visible hard bump in middle area of heel just above heel bone. Occasionally (not often tho) also have pain in toes when walking.
PS: Have very high arches & have had life-long 247 "burning feet" sensation altho feet are cool. Have also had "Wandering Leg" Syndrome all my life.
I am a Sassa pensioner with no medical aid & cannot afford extensive consultations & treatment or surgery.
PS: I've put on 20+kgs since retirement & have noted the advice about weight. I've also stopped HRT due to cost. I've also stopped all exercise & walking as I'm terrified of more damage. Hence the weight gain. I use Reparil Gel a few times a day plus take 1xBrufin + 2xPanado when necessary - not more than 1ce pd.
From being an active, healthy person looking forward to an active retirement, I now live a pathetic, "lazy", semi-cripple existence.
So, you've already figured out 1 part of what can help the pain settle - sticking to the right shoes + inserts. This video can also give you some ideas of how you can start easing back into more activity while getting the pain to settle: ua-cam.com/video/A2j-fk9X1G0/v-deo.html
The main thing is to keep your walking pace slow and to start with very little and then build it slowly over time. You have also given me an idea for more videos - I'll make one that demonstrates some exercises that may help reduce pain.
@@TreatMyAchilles Thank you SO very much for the quick response!! Much appreciated. Dankie Baie van SA xx
Is there a link between plantar fasciitis and Achilles tendonitis?
There are quite a lot of people who get both conditions at the same time - there is no evidence that support a direct link but my theory is that it is one of the following:
1. The original injuring activity they did was hard enough to strain both areas, or
2. They have a different underlying issue (biomechanical) or health (diabetes or menopause or something else) that made any fascia or tendon structure more susceptible to injury
Hello. I ruptured my Achilles in Vietnam back on September the 7th but was unaware until 1.5 months later. I’ve returned to AmericaI and had surgery on Oct. 31st, and my doctor told me November 9th everything was great, I was ahead of schedule, placed in a boot, fully weight bearing, and can start rehab.
My only issue is I’m out of state in regards to insurance, so as of now I cannot do rehab.
He also told me I could swim after one week and dorsiflexion was allowed. For rehab, he said 2 days a week, for 6 weeks.
Any recommendations or insight? I’m unsure if I’ll be able to rehabilitate at a facility before returning to Vietnam December 1st because of insurance limitations.
Thank you!!!
It is difficult to know what is exactly right for you without knowing the full extent of your situation but this video about rehab post surgery may be useful: ua-cam.com/video/uF8d36TDacw/v-deo.html
Thank you! ❤
I have a knot inside my Achilles on right side of right ankle. I keep wondering if that’s why I can’t walk with my right foot normally. I have been to two physical therapy appointments and received a few exercises, but they just produce more pain because I have plantar fasciitis with Achilles tendinitis. And it seems impossible to deal with altogether. I can’t find any shoes that feel good. The plantar fasciitis had gotten much better but then when I started doing the PT exercises and trying to find shoes and insoles that would work it just got worse again. I am most worried about this Achilles tendinitis because that’s new for me. I am not a runner. I am not an athlete…..makes no sense. I cannot wear custom orthotics or anything that pushes into my arches at all. I found that out in the late 90s when I had plantar fasciitis then. The only thing that helped was an outdoor spa with a geyser jet that released the muscles in my calves. But I don’t have access to that anymore. The more I push on the knot the more it hurts. I cannot bend my foot back, and I have never been flexible. Any input appreciated.
It is normal to have a lump in your Achilles when you have tendonitis - I explain why this happens in this video: ua-cam.com/video/nAUrK0lRC6A/v-deo.html
It sounds as if the exercises you were given for your Achilles may just have been a bit too intense for your foot. They should likely just be introduced at a much lower level.
If you want rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
I have gotten my Achilles tendon last year and I was treated but anytime I apply pressure on it like shooting ball with power then I fell the pains for some time then it goes away again please any advice for me thanks
It may be that you actually have posterior ankle impingement - it can cause pain in the same area but it is the ankle joint rather than the tendon that is injured - this video explains more about it ua-cam.com/video/B6xADphGRP4/v-deo.html
What type of doctor should I see to have my tendinitis evaluated? Podiatrist? Or foot and ankle? Or physical therapist?
A physical therapist would be best as they will be able to prescribe a rehab plan at the same time. But all 3 you listed will be able to diagnose it.
@@TreatMyAchilles thank you so much!
Help! Thanks so much for your video. My wife is suffering from tendinosis (for months), has swelling in her affected ankle and we're coming up with an ongoing plan including regular ice, elevation and massage (actually bought a massage table) with a gua sha. Question is how often should I be performing calf/Achilles massage for maximum benefit. How much time is needed between each session to allow for healing? Thank you!
Massage does not really do anything for healing this conditions - it can just offer some short term pain relief. To get this to recover she needs to also be doing the correct exercises and load management.
Thanks for this video it is very very informative!! I have had Tendinopathy for a month or more now due to re injury during workouts.. However I am in therapy and getting better by the week HOWEVER, I wanted to understand why you think night splints are not effective?? I have tried them on and off for several weeks and days now and in my opinion, as a stomach sleeper it is very effective in relieving morning stiffness and pain. Going to sleep without one on is almost guaranteed to bring pain to my foot in the morning.. if I sleep with it on, I have just about zero heel pain in the AM...
Thank you for sharing your experience - every person is different so it is valuable to have different reports. Our patients have never found them useful and quite often it actually interfered with their sleep. But perhaps it is that the position you like to sleep in is the key as to why your tendon feels better with it? So perhaps stomach sleeping puts the foot in a position that irritates the tendon and the splint stops you doing it?
PLEASE NOTICE 🥶,,,,,I don't have pain in Achilles.
But I feel irritating clicking sensations while doing physical activities.(it's been 3 weeks) And feel strong popping painly sensation while bending Achilles tendon.(did X ray- there was no rupture)
I feel very risky to back in sports due to these.
What can I do??
Not possible to say for sure what's going on without having assessed you, but maybe this video will help: ua-cam.com/video/nMg-TDBWpcc/v-deo.html
You should make a video about extensor tendonintis. I'm unfortunately in a tough situation where I have both extensor and Achilles tendonintis.
👍Added it to the list.
The relative rest convinces me, I had the pain on the left leg last year after 2 months rest, the pain disappeared. This year I got it on the right leg again, and after every 2 weeks I go back to play soccer and the pain comes back mmmm the rest is unavoidable. Thanks
You're welcome.
Does the leg press machine at the gym make Achilles tendonitis worse? I've still been able to push quite heavy on this particular exercise but im not sure if it's a good thing to do with an Achilles injury...
You will have to test and observe how your injury reacts in the 24 hours after. It might cause trouble for insertional Achilles injuries or if you push too much with the front of your foot.
The rule with rehab and exercise is usually that it is OK to do as long as:
1. It only causes a slight discomfort while doing it, AND
2. It does not cause an increase in your pain and swelling that lasts for more than 24 hours
@@TreatMyAchilles thank you for your response and advice 👍
Can i asked a question I think i have pull my tendon by dancing constantly i don't know if that is what caused it. But at first i thought id pulled my calf muscle.
My friends said to stop dancing until it heals
I have not gone to the GP with it
What do you suggest i do Stop heavy dancing or No dancing i am taling Zumba dancing for 15 mins
I can't provide safe advice without assessing you because I don't know how serious your injury is. It is best you get it assessed by a healthcare professional.
This is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
I have insertional achilles tendonitis and it is just the worst pain I cannot walk right haven't been able to walk right for a while now and nothing seems to work I don't know what to do about it put my quality of life is not where it needs to be
Hi there,
You're welcome to book a video consultation with one of our physios if you would like an assessment and a personalised treatment plan: www.sports-injury-physio.com/
Tried many therapies. Heel dips throuout the day for 2 weeks cured me. I limped for almost 2 years.
I’ve been limping for almost 9 months!! I’m miserable. Exercising isn’t working.
How do I know for sure if something is insertional Achilles or regular Achilles tendonitis pain?
I have mostly tendon pain but only certain angles sometimes and under foot hurts as well but the tendons the most
It is not that easy to explain because you need to use info gathered from all the elements of the assessment - I discuss it in more detail here: ua-cam.com/video/cNOxd3w37K0/v-deo.html
@@TreatMyAchilles thanks!
Thanks, this is great. Can you do a Treat My Shoulder channel now? : )
:) We do have a shoulder playlist with 9 videos on our other Channel for general sports injuries. Here it is: studio.ua-cam.com/users/playlistPLkRW4ITRa6bDl8AaYnbNTOA7Uj-fs41vN/videos
You could also take a look at the Shoulder and Upper Arm section of our related website: www.sports-injury-physio.com/shoulder-upper-arm
Hope this helps!
What if you have tendinitis with a tear in the tendon?
That is quite common - you can find advice on treating partial Achilles tears (these usually occur in combination with tendonitis) here: ua-cam.com/video/O9E-PkGPZrM/v-deo.html
The treatment is very similar to that of Achilles tendonitis except that you usually have to protect the tendon a bit more by wearing shoes with heels or heel lift inserts for a few weeks.
I'm surprised that there was no mention of chiropractics. I imagine better alignment would help. But from what I gather is that the way to resolve the issue is to strengthen the tendon. What are your thoughts on chiropractics? Helpful or not?
It doesn't play a role in recovering from Achilles tendonitis
Thanks! Did a few sets of light calf raises and my pain started to go away and I was able to walk again.
Wonderful!
How about a tens unit?
TENS might help with temporary pain relief but it doesn't really do anything for healing. So, if you have a unit, you can use it but it's not something I would buy.
How do you feel about the Topaz Procedure?
I would only advise to have it in cases where rehab and other treatments have not worked because it falls under surgery (better than open surgery but still surgery) - they remove part of the tendon through radiofrequency. So my treatments of preference would be:
1. Rehab and load management
2. Injections like PRP or shockwave, combined with rehab
3. Minimally invasive surgery like Topaz or Tenex
4. Open surgery but this should really be left as a super last resort as the recovery from this is not great.
Avoid steroid tablets and injections at all cost - I would go for Topaz and Tenex before steroids. Only consider steroids if the last option is Open Surgery.
@@TreatMyAchilles I've been dealing with tendonsis for about 5 or so years now. So far I have done cortozol injection, and many months of PT. Durring my last visit with my foot doctor he offered me a more powerful injection, as well as oral steroids, or the topaz. I think I am leaning more towards the Topaz.
I was thinking maybe more PT after the topaz would be a good idea?
KT tape. Good or waste?
Here's our video on taping for Achilles tendonitis: ua-cam.com/video/gu53pA_2ri0/v-deo.html
I play soccer and futsal. About 3 weeks ago I noticed pain and stiffness in my Achilles when I was reffing, I suspected this is due to overuse as I hadn’t had a break in about 2 weeks. I played the next day and came off after half time as it was too sore. I took 5 days off and on the 6th day I was in Thailand playing futsal, I trained and played the next day and was in pain and stiffness. A proffessional physio was by my side and managed my load, over the week I was in varied pain but it definitely effected my performance. I took 5 days off after the tornament and walked. Pain was received so I trained 100% at futsal and noticed a little pain and crepitus (I had for the full time) so I took 4 days off again and I am beginning eccentric and icometric contractions now :)
What’s weird is that when I wear a shoe with more of a heel, the tendon hurts more… and for days.
Two things that spring to minds are:
1. Are the shoes perhaps pressing on the painful bit? That could make it worse.
2. Perhaps your pain is coming from something being pinched in the back of the heel joint which can cause pain in the same area of the Achilles - if that is the case, then wearing a shoe with a heel will irritate it because it will make it pinch more.
@TreatMyAchilles I am suffering with achillis tendonpathy the last 13 months, physio, rest, walk fir 4 mins run for 1 min, shockwave theraphy and still in so much pain I cannot run. I have heel lifts in my trainers, I've done all recommended exercises and one year on still in pain, any advice please 🙏
How much heel raise should I have?
Just a bit - test what feels good to stand and walk in.
@@TreatMyAchilles okay will do
Just discovered your helpful videos. I received a boot today bcs it was too painful to walk at all - couldn't tolerate any weight. I see there's a controversy surrounding the treatment of this malady. Perhaps I'll consult with you if the tendon isn't better after 2 weeks in the boot. Thanks for the valuable info.
You're welcome!
I commented below but don't see a way to add to it. As a newbie to insertional Achilles tendonitis, the more I read about your approach the more I realize how suboptimal my initial experiences have been with a podiatrist/foot & ankle surgeon.
I'm in the U.S (NYC) and I know what triggered this problem - 2 years of inactivity due to long COVID - then getting back to things whilst the tendons (and everything else) were basically atrophied.
Just wondering if you can deal with the time zone thing. Based on past experiences with horses, I completely agree that immobilization caused more harm than good. TIA.
Maryke, if achilles tendon rehab can take 12 months, how long can meniscus injury rehab take?
Recovery times can vary a lot, depending on age and some other factors. Here's my video on meniscus tears (from my other UA-cam Channel) - you can jump to the Chapter "Recovery times for meniscus tears" if you don't want to watch all of it:
ua-cam.com/video/C6loNMqxj7A/v-deo.html
@@TreatMyAchilles Thanks very much. That video was very helpful 🙏
I actually believe there is only one sure way of getting rid of Achilles tendonitis a real cure and that is shockwave therapy once a week for 3 weeks and can take up to 3 months to work but work it does , it makes everything else fluff and redundant.
It does work for some people but not for everyone - definitely something to try.
Would beef broth help with building up the fibres?
I don't know about beef broth. Here's our video about supplements that have been researched: ua-cam.com/video/HMpcNOUhS14/v-deo.html